Actinomycosis of the Gallbladder: A Case Report

Abstract

Abstract: Actinomycetes are a normal part of the microflora of the cervicofacial region and gastrointestinal tract, but they can cause infections when the normal mucosal barrier is lost due to surgery, trauma or infections. Actinomycosis of the gallbladder is extremely rare. A 70-year-old man with ischaemic heart disease, hypertension, non-insulin dependent diabe-tes mellitus and hypercholesterolaemia presented with episodes of acute pancreatitis and cholecystitis. CT scan suggested a perforated gallbladder. The liver was normal. At cholecystectomy the gallbladder was contracted with adhesions and a probable cholecystodocho-duodenal fistula. Histology showed an inflamed and fibrotic gallbladder with colonies of Actinomyces, the so-called ‘sulphur granules’. Postoperatively, he has been well. Keywords: Gallbladder, actinomycosis. INTRODUCTION Actinomycosis usually involves the head and neck re-gion, thorax and abdomen. Pelvic actinomycosis may occur in women using intrauterine contraceptive devices. Abdomi-nal actinomycosis is rare, usually occurring in the caecum and appendix. Actinomycosis of the gallbladder is extremely rare; to date only 20 cases involving the gallbladder or bile duct have been reported [1-23]. We report a further case of actinomycosis of the gallbladder and review the literature.